Over recent years, there has been a growing interest in measuring equity of access to health care and health outcomes. In operational terms, pursuing equity in health translates to eliminating health disparities that are systematically associated with underlying social disadvantage or marginalisation. There may be an assumption that programmes targeting rural and remote locations are by virtue equitable, as they aim to reach the poorest and most marginalised individuals and communities. However, without assessing the socio-demographic and -economic profile of programme participants, these suppositions are no more than assumptions, as even in the most remote locations such programmes may only be reaching and having an impact on those individuals who are comparatively advantaged, thus failing to meet the needs of the most underserved in the population.
The Co-ordinated Approach To Community Health (CATCH) programme is an international development programme funded by the UK Department for International Development (DFID) and implemented by Sightsavers in Eastern and Southern Africa with the aim to increase the coverage of eye health services in trachoma-endemic areas, including diagnosis and treatment of cataract, refractive error, conjuctivities and other eye conditions. This programme was used to collect data on disability status and socio-economic charcteristics of individuals presenting in trachoma/CATCH camps to understand the extent to which the programme reaches individuals at most need and to provide recommendations to improve equity of access to eye care services.
The purpose of this research was to test various tools and assess the disability status and the relative and absolute wealth of programme participants presenting in trachoma/CATCH camps in Kasungu district, Central Malawi.
This is one of a few studies, which collected data on socio-economic characteristics and disability status of patients attending outreach camps with the aim to measure access to these services by different population groups. The study showed that the application of both wealth measurement tools and disability questions in eye care camps is feasible and does not create a significant burden for programme activities. The use of the tools have proven to be reliable and effective, and the findings have important programmatic value, as they help to better understand the profile of the populations the outreach activities aim to serve. Future outreach programmes should continue collecting disaggregated data to measure equity of service delivery and ensure that no one is left behind.